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半月板根撕裂:术前和术后 MRI 表现的更新。

Meniscal Root Tears: An Update Focused on Preoperative and Postoperative MRI Findings.

机构信息

Department of Musculoskeletal Radiology, Fleury Medicina e Saúde, Sao Paulo, Brazil.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Ste 350, San Francisco, CA 94158.

出版信息

AJR Am J Roentgenol. 2022 Aug;219(2):269-278. doi: 10.2214/AJR.22.27338. Epub 2022 Mar 16.

Abstract

Meniscal root tears represent radial tears or avulsions of the meniscal cartilage at the tibial attachment site that profoundly affect meniscal biomechanics and kinematics. Meniscal root tears have the functional effect of a total meniscectomy and can lead to rapid degenerative change with development of early knee osteoarthritis (OA). A growing range of arthroscopic surgical techniques have been developed to repair meniscal root tears with the aim of restoring joint kinematics and contact pressures and delaying the development of OA. With increased understanding of the anatomy and biomechanics of the meniscal root, meniscal root injury repair has become the treatment of choice in knees with nonadvanced OA. This article reviews the anatomy and biomechanics of the meniscal roots, clinical and imaging diagnostic criteria of meniscal root tears, correlation between arthroscopy and MRI in the diagnosis and classification of meniscal root tears, and expected and abnormal MRI findings after meniscal root repair. Familiarity with MRI signs and classifications of meniscal root tears, as well as with root repair surgical techniques, can aid radiologists in correctly reporting preoperative and postoperative MRI findings.

摘要

半月板根撕裂代表半月板软骨在胫骨附着处的放射状撕裂或撕脱,严重影响半月板的生物力学和运动学。半月板根撕裂具有全半月板切除术的功能效果,并可能导致快速退行性变化,从而导致早期膝关节骨关节炎 (OA) 的发生。为了恢复关节运动学和接触压力并延迟 OA 的发展,已经开发出越来越多的关节镜手术技术来修复半月板根撕裂。随着对半月板根解剖和生物力学的深入了解,半月板根损伤修复已成为非晚期 OA 膝关节的首选治疗方法。本文综述了半月板根的解剖和生物力学、半月板根撕裂的临床和影像学诊断标准、关节镜和 MRI 在半月板根撕裂诊断和分类中的相关性,以及半月板根修复后的预期和异常 MRI 表现。熟悉半月板根撕裂的 MRI 征象和分类,以及根修复手术技术,有助于放射科医生正确报告术前和术后的 MRI 结果。

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